I say combine the professions of PT and OT thus ending the territory issue and 
what we can and cannot do.  I see what you described as exactly what I would do 
as a PT....but, I know you are just as competent and good at is as I am, Ron....

So, lets combine the 2 professions.

David A. Lehman, PhD, PT

Associate Professor

Tennessee State University

Department of Physical Therapy

3500 John A. Merritt Blvd.

Nashville, TN 37209

615-963-5946

dleh...@tnstate.edu

Visit my website:  http://www.tnstate.edu/interior.asp?mid=2410&ptid=1

 

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-----Original Message-----
From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of 
cmnahrw...@aol.com
Sent: Wednesday, February 04, 2009 11:50 AM
To: OTlist@OTnow.com
Subject: Re: [OTlist] From Standing to Toilet Transfers

Bravo!!!? I believe that is task analysis at its absolute best.? Taking the 
foundational skills and working up the ladder towards her occupational goal.

I view hand therapy and stroke rehabilitation in the same light. Working on the 
foundational skills in order to work towards an occupatioanal goal.

Chris Nahrwold MS, OTR


-----Original Message-----
From: Ron Carson <rdcar...@otnow.com>
To: OTlist@OTnow.com
Sent: Tue, 3 Feb 2009 10:40 pm
Subject: [OTlist] From Standing to Toilet Transfers



A  while  back  on  an  AOTA  forum,  I  was "criticized" for working on
mobility  when  there  were not obvious occupational forms present (i.e.
toilet,  shower, chairs, etc). At least one person's contention was that
working  on mobility in the absence of an occupational form is not OT. I
want  to  share a quick case study which highlights why I take exception
with  the person's comments.

For  the  sake  of  brevity,  I'll keep "Jane's" case study as simple as
possible.

####################################################################

Jane  has  a  spinal  condition leaving her with partial lower extremity
paralysis. The patient's initial goals are of course to walk but also to
transfer  to  her  toilet,  shower, etc. Again for brevity, she wants to
learn "skills for the job of living".

Initially,  the  patient  was  unable  to  stand, so we began working on
standing.  This required maximum, and I mean max, assistance x1. At this
early stage, the patient was unable to use a walker. After a week or so,
I  progressed  the  patient  to  a  walker,  but she still required knee
blocking  to  stand.  Eventually,  the patient was able to stand without
knee blocking and finally began taking steps. After she was able to walk
10-15  feet with a rolling walker, we tried transfers from wheelchair to
wheelchair.  This  was  very difficult and required continuing practice.

After  approximately  6  weeks  of  almost  daily OT, TODAY, the patient
transferred  from  her  w/c  to  her toilet using a walker. She required
assistance  with  sit  to  stand  and cuing with the transfer but it was
essentially  her  doing  the transfer. This is a huge milestone for this
patient  and  made her VERY happy and optimistic that her life was going
to again have some semblance of "normal".

##################################################################

Now,  in my opinion, I have been working on occupation from day ONE! The
patient  had occupation-related deficits, her barriers were identified I
was  competent  to  address  thos
e  barriers  and  the  patient had good
potential to make significant progress towards her goals.

So  what  do  you  think?  Should  OT work on mobility/ambulation in the
immediate absence of occupational forms? Should OT address mobility from
the very beginning, if mobility is a barrier to occupational goals?

I'm interested to hear what other's say!

Thanks,

Ron

--
Ron Carson MHS, OT
www.OTnow.com


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